全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
华西医学  2015 

系统性红斑狼疮合并股骨头坏死行全髋关节置换术围手术期处理

DOI: 10.7507/1002-0179.20150249, PP. 865-868

Keywords: 系统性红斑狼疮,全髋关节置换,股骨头坏死,糖皮质激素,围手术期

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的?探讨系统性红斑狼疮(SLE)激素治疗导致股骨头缺血性坏死(ANFH)行全髋关节置换术(THA)患者的围手术期特殊处理方法。方法?回顾性分析2009年8月-2012年11月27例(40髋)SLE合并中晚期ANFH行THA的患者的病历资料,对围手术期处理以及合并症、并发症进行分析总结。其中男5例,女22例;年龄21~66岁,平均40岁;单髋置换14例,同期双髋置换2例,分期双髋置换11例。合并症高血压2例,慢性支气管炎1例,自身免疫性肝病、肝功能不全1例,干燥综合征2例,贫血2例。结果?27例患者围手术期病情平稳,未发生肾上腺皮质功能危象。共发生并发症4例,其中1例发热反应(最高体温39.3℃),1例切口脂肪液化,1例肺部感染,1例关节脱位。患者术后均获随访,时间24~53个月,无感染、假体松动、假体周围骨折及深静脉血栓形成的发生。结论?SLE合并中晚期ANFH患者行THA围手术期并发症发生率较高,但经过规范围手术期的处理,包括激素和抗生素的使用,及抗骨质疏松治疗,并重视手术并发症预防和处理,选择好手术时机,可使患者安全渡过围手术期。

References

[1]  3 Issa K, Naziri Q, Rasquinha VJ, et al. Outcomes of primary total hip arthroplasty in systemic lupus erythematosus with a proximally-coated cementless stem[J]. J Arthroplasty, 2013, 28(9): 1663-1666.
[2]  4 Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment[J]. J Bone Jiont Surg Br, 1985, 76(1): 3-9.
[3]  5 Arlet J, Mazieres B. Natural development of non-traumatic osteonecrosis of the hip[J]. Acta Orthop Belg, 1999, 65(Suppl 1): 47-50.
[4]  6 Orban H, C?rstoiu C, Adam R. Total hip arthroplasty in secondary systemic lupus erythematosus femoral head avascular necrosis[J]. Rom J Intern Med, 2007, 45(1): 123-129.
[5]  7 Abu-Shakra M, Urowitz MB, Gladman DD, et al. Mortality studies in systemic lupus erythematosus. Results from a single center. I. Causes of death[J]. J Rheumatol, 1995, 22(7): 1259-1264.
[6]  8 Ward MM, Pyun E, Studenski S. Causes of death in systemic lupus erythematosus. Long-term followup of an inception cohort[J]. Arthritis Rheum, 1995, 38(10): 1492-1499.
[7]  9 Takahashi T, De-La-Garza L, Ponce-De-Leon S, et al. Risk factors for operative morbidity in patients with systemic lupus erythematosus: an analysis of 63 surgical procedures[J]. Am Surg, 1995, 61(3): 260-264.
[8]  10 Ito H, Matsuno T, Hirayama T, et al. Health-related quality of life in patients with systemic lupus erythematosus after medium to long-term follow-up of hip arthroplasty[J]. Lupus, 2007, 16(5): 318-323.
[9]  1 Kang Y, Zhang ZJ, Zhao XY, et al. Total hip arthroplasty for vascular necrosis of the femoral head in patients with systemic lupus erythematosus: a midterm follow-up study of 28 hips in 24 patients[J]. Eur J Orthop Surg Traumatol, 2013, 23(1): 73-79.
[10]  2 Woo MS, Kang JS, Moon KH. Outcome of total hip arthroplasty for avascular necrosis of the femoral head in systemic lupus erythematosus[J]. J Arthroplasty, 2014, 29(12): 2267-2270.
[11]  11 Zangger P, Gladman DD, Urowitz MB, et al. Outcome of total hip replacement for avascular necrosis in systemic lupus erythematosus[J]. J Rheumatol, 2000, 27(4): 919-923.
[12]  12 Henriques HF, Lebovic D. Defining and focusing perioperative steroid supplementation[J]. Am Surg, 1995, 61(9): 809-813.
[13]  13 袁燕林, 吕厚山, 林剑浩, 等. 服用激素的类风湿关节炎患者人工全膝关节置换术[J]. 中华骨科杂志, 2003, 23(10): 619-621.
[14]  14 曾春, 宋炎成, 蔡道章, 等. 系统性红斑狼疮合并股骨头坏死行全髋关节置换术的特点及其并发症的防治[J/CD]. 中华关节外科杂志: 电子版, 2009, 3(4): 454-458.
[15]  15 董健文, 黄冬梅, 戎利民, 等. Ⅰ期双侧全髋关节置换治疗系统性红斑狼疮合并股骨头坏死的早中期疗效[J]. 中华损伤与修复杂志: 电子版, 2008, 3(6): 705-711.
[16]  16 黄立羡, 练克俭, 郭林新, 等. 系统性红斑狼疮激素治疗后股骨头坏死行人工全髋关节置换术围手术期处理[J]. 临床骨科杂志, 2012, 15(6): 607-609.
[17]  17 郭予立, 胡奕山, 林本丹. 合并系统性红斑狼疮的股骨头坏死患者行全髋关节置换术的疗效评估[J]. 广东医学, 2013, 34(19): 2984-2986.
[18]  18 Arabmotlagh M, Rittmeister M, Hennigs T. Alendronate prevents femoral periprosthetic bone loss following tota1 hip arthroplasty: prospective randomized double-blind study[J]. J Orthop Res, 2006, 24(7): 1336-l341.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133